Gumenyuk Valentina, Korzyukov Oleg, Peled Noam, Landazuri Patrick, Taraschenko Olga, Parker Sheridan M, Frank Darya, Pavuluri Spriha
Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68131, USA.
MGH/HST Martinos Center for Biomedical Imaging, Charlestown, MA 02129, USA.
Brain Sci. 2025 Aug 28;15(9):938. doi: 10.3390/brainsci15090938.
Patients with generalized epilepsy are rarely referred for advanced diagnostics like magnetoencephalography (MEG). This is due to the assumption that generalized seizures cannot be localized noninvasively. We present simultaneous MEG (306 channels) and EEG (64 channels) data from seven patients with drug-resistant generalized epilepsy. Three patients experienced typical generalized seizures during their MEG clinical evaluation. In total, 38 epileptiform events (three seizures, 35 interictal discharges) were analyzed using two software platforms and three localization methods: equivalent current dipole (ECD), sLORETA (via SWARM), and dynamic statistical parametric mapping (dSPM). Individual head models were created from each patient's MRI. MEG successfully localized seizure onset zones, showing distinct hypersynchronous discharges on all sensors as well as alternately during interictal discharges. Localization was consistent across methods and generalized events within subjects, revealing cortical sources in all cases, with rapid propagation (27-60 ms) across networks. This study demonstrates that MEG can meaningfully localize both seizures and interictal discharges in generalized epilepsy. This supports a broader use for MEG beyond focal epilepsy. Incorporating MEG in drug-resistant cases including generalized epilepsies may improve diagnosis and guide treatments including non-surgical options.
全身性癫痫患者很少被转诊去做像脑磁图（MEG）这样的先进诊断检查。这是因为人们认为全身性癫痫发作无法通过非侵入性方法进行定位。我们展示了7例耐药性全身性癫痫患者的同步MEG（306个通道）和脑电图（EEG，64个通道）数据。3例患者在MEG临床评估期间经历了典型的全身性癫痫发作。总共使用两个软件平台和三种定位方法对38次癫痫样事件（3次发作，35次发作间期放电）进行了分析：等效电流偶极子（ECD）、标准化低分辨率脑电磁断层成像（sLORETA，通过SWARM）和动态统计参数映射（dSPM）。根据每位患者的磁共振成像（MRI）创建了个体头部模型。MEG成功定位了癫痫发作起始区，在所有传感器上均显示出明显的超同步放电，在发作间期放电时也交替出现。不同方法之间以及个体内的全身性事件的定位结果一致，在所有病例中均揭示了皮质来源，并在网络中快速传播（27 - 60毫秒）。这项研究表明，MEG能够有效地定位全身性癫痫中的癫痫发作和发作间期放电。这支持了MEG在局灶性癫痫之外更广泛的应用。将MEG纳入包括全身性癫痫在内的耐药性病例中，可能会改善诊断并指导包括非手术选择在内的治疗。
